Hair Loss in Men and Women (Alopecia)

Gary W. Cole, MD, FAAD

Dr. Cole is board certified in dermatology. He obtained his BA degree in bacteriology, his MA degree in microbiology, and his MD at the University of California, Los Angeles. He trained in dermatology at the University of Oregon, where he completed his residency.

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

What are causes of hair loss?

Because there are so many types of scalp hair loss, finding the cause can be challenging. This review will cover the most common causes of hair loss occurring on normal scalp skin. The medical term for hair loss is alopecia.

Most hair loss is not associated with systemic or internal disease, nor is poor diet a frequent factor. Hair may simply thin as a result of predetermined genetic factors and the overall aging process. Many men and women may notice mild physiologic thinning of hair starting in their 30s and 40s. Life vicissitudes, including illness, emotional trauma, protein deprivation (during strict dieting), and hormonal changes like those in pregnancy, puberty, and menopause may cause a reversible hair loss.

Several health conditions, including thyroid disease and iron deficiency anemia, can cause hair loss. While thyroid blood tests and other lab tests, including a complete blood count (CBC), on people who have ordinary hair loss are usually normal, it is important to exclude underlying causes in sudden or severe hair loss. Such basic health screening can be done by a family physician, internist, or gynecologist. Dermatologists are doctors who specialize in problems of skin, hair, and nails and may provide more advanced diagnosis and treatment of hair thinning and loss. Sometimes a scalp biopsy may be taken to help in diagnosis of severe or unexplained hair loss.

Although many medications list "hair loss" among their potential side effects, most drugs are not likely to induce hair loss. On the other hand, cancerchemotherapy and immunosuppressive medications commonly produce hair loss. Complete hair loss after chemotherapy regrows after six to 12 months.

Hair Loss and Stress

Is there a correlation between hair loss and stress?

Both emotional and physical stress (such as a serious illness or recovery from surgery) have been associated with hair loss. It is possible that stress induces hormonal changes that are responsible for the hair loss, since hair loss is a known consequence of other hormonal changes due to pregnancy, thyroid disturbances, or even from taking oral contraceptives.